The field of this invention relates to a positioning apparatus for positioning a patient undergoing X-ray examination of the cervical portion of the spine in order to obtain an unobstructed lateral X-ray of the cervical spine.
In dealing with any accident patient, especially anyone who is unconscious, there is always a definite concern that the patient may have a spinal injury, such as a broken back. Moving of any such patient may further aggravate the injured back and possibly even may cause paralysis or death.
Within the emergency medical field it is common to utilize at the scene of an accident a board upon which the patient is placed in a prone position. The board is what is commonly referred to as a "spine board". The patient is positioned with the patient's back in direct contact with the board. The patient and board are then transported to the emergency room of a hospital.
Every traumatized patient who enters the emergency room of a hospital is under "C-spine precautions". This means that before further diagnostic tests can begin, the emergency physician must visualize the cervical spinal vertebrae radiographically. Radiographic observation of the cervical section of the spine must be accomplished laterally, that is, from the side of the patient. The X-ray beam must pass unobstructed in a perpendicular relationship to the cervical vertebrae in order to obtain an adequate X-ray. If an adequate cross table lateral X-ray of the sixth and seventh vertebrae is not obtained at this time, there is a tremendous potential morbidity involved.
Accurate lateral radiographs of the cervical vertebrae are difficult to obtain because of the interference from the shoulders of the patient. The shoulders naturally block the view of part of the sixth and all of the seventh vertebrae. Therefore, with a patient occupying a normal at rest position, the shoulders prevent radiograph observation of a part of the sixth and all of the seventh vertebrae which will allow injury to these two vertebrae to go undetected. Movement of the patient and injury to either one of these vertebrae could result to obligating that patient to life in a wheelchair.
The normal procedure currently in use in emergency rooms is the archaic method of physically pulling by an X-ray technician on the patient's arms in order to displace the shoulders sufficiently downward so that the X-ray beam is hopefully not obstructed in obtaining a radiograph of the C6 and C7 vertebrae. The disadvantage of this method is that displacement of the shoulder by the technician is not adequate to clear the view of the entire cervical area. Also, this requires that the technician remain in the radiographic room during the X-ray exposure which undesirably risks the technician to radiation.
Previously there have been attempts of constructing a board which facilitates the obtaining of a single satisfactory radiograph exposure of the C6 and C7 vertebrae of a traumatized human being. Examples of such previous devices are shown within U.S. Pat. Nos. 3,629,581, 4,127,120 and 4,383,524. Each of these prior art devices utilize a series of straps which are to be attached to the arms of the patient and the straps utilized in conjunction with the legs of the patient to exert a force in a downward direction on the arms to pull the shoulders sufficiently to facilitate the taking of the necessary X-ray. Installation of any one of these prior art devices is complicated and time consuming. Also, if the patient is unconscious any strap-type device may be ineffective.
There is a need to construct a device that will aid a physician to quickly obtain a single cervical radiograph of any patient, whether conscious or unconscious, which can be quickly and easily installed in conjunction with the patient by individuals of minimum skill.